Prevalence of Tooth Loss due to Periodontitis in Patients Visiting Tertiary Care Hospital

Introduction: Epidemiological studies have been showing that caries is the main reason for tooth loss. But nowadays, it seems to show an increasing trend of tooth loss due to periodontal reasons rather than caries. The retention of natural teeth can improve the quality of life by maintaining the ability to chew and digest food. Thus, directly or indirectly periodontitis leading to tooth loss affects quality of life. Objective: To determine the prevalence of tooth loss in periodontitis patients. Methods: A cross-sectional study was done in Department of Periodontology and Oral Implantology from June 2023 to September 2023 after obtaining ethical clearance from institutional review committee. Study participants were patients diagnosed as periodontitis according to world workshop in periodontics 2017 classification and prevalence of tooth loss was recorded according to the history of mobile tooth. Poor prognosis and hopeless prognosis were counted as to be extracted tooth in the study. Collected data were entered into the excel sheet and further statistical analysis was done using SPSS v.20. Results: Mean of tooth loss due to periodontitis was found to be 3.74±3.285 and tooth to be extracted is 1.94±1.884. Conclusion: As the age increases number of tooth loss increases, likewise current smokers have more amount of tooth loss than that of former and nonsmokers. Likewise, mandibular anterior region was most common for prevalence for tooth loss.


INTRODUCTION
Periodontal disease is an infectious disease characterized by inflammation and subsequent destruction of the supporting structures of the teeth. 1 In a recent study done by Global burden of disease states that seventh most common prevalent disease worldwide is severe periodontitis with prevalence of 11.2% and affected people were around 743 million and there was increase in global burden of periodontal disease from 1990 to 2010 by 57.3%. 2 It is already recognised that severe periodontal disease affects certain group of individuals that appear to exhibit increased susceptibility to periodontal destruction. 3.Sachita Thapa, 1 Dr. Arjun Hari Rijal, 1 Dr. Manoj Humagain, 1 Dr. Simant Lamichhane, 1 Dr. Sita Bhusal 1 1 Department of Periodontology and Oral Implantology, Kathmandu university school of medical sciences, Dhulikhel, Nepal.
Retention of the teeth is a main aim of dental treatment. 4A combination of surgical and nonsurgical therapies is the management of periodontal disease. 1 The success of periodontal therapy is usually measured in terms of maintenance or improvement in clinical attachment levels. 1 Tooth loss directly or indirectly affects quality of life. 5 our knowledge there has been very few data on the prevalence of tooth loss among periodontitis patients at the time of dental visit in Nepalese population.
Therefore, the present study was aimed to evaluate the prevalence of tooth loss among periodontitis patients and its association with gender and smoking habit.

RESULTS
The anterior tooth loss is the most common which is similar to our study. 13While some study contradicts our study where maxillary posterior tooth has seen with more bony defects in cone beam computed tomography, thereby resulting in maxillary posterior tooth being most common site for periodontitis. 14st common reason for loss of tooth is mobility due to periodontitis where as high as 67.2% of lower anterior was lost due to mobility amongst other causes like furcation, pocket involvement or combination of these. 15Smoking directly and indirectly plays a role in periodontitis where prevalence of periodontitis changes with change in smoking rate which was showed by a 40 years longitudinal study of Sweden. 16ong Nigerian population tooth loss was found to be more frequent in diabetic patients than in systematically healthy patients 17 , likewise tooth loss due to caries is more common than periodontitis in younger age 18 has been shown in some literature. 19om the literature it has shown that prevalence of tooth might affect by Diabetes, dental caries other than periodontitis.Whereas this study is amongst few one where retrospective study is done to relate tooth loss and periodontitis who are systematically healthy.This study resulted in mandibular anterior to be most frequent region to lose tooth because of single root and traumatic occlusion might be the region to lead more amount of destruction. 4is finding of current study has limitations as well where this study was conducted in the single center/ hospital setup with limited sample size, so the results  4).
Prevalence of tooth loss in male (mean 3.90±3.238)was found to be more than that of females (mean 3.60±3.335).Mean of tooth loss due to periodontitis out of 216 patients was found to be 3.74±3.285and tooth to be extracted is 1.94±1.884.(Table 5)

DISCUSSION
This study was accomplished in order to find the prevalence of tooth loss amongst periodontitis patients.Furthermore, also compares with age, gender, sites involved and smoking status.In 2010, about 2.3% of the global population representing 158 million people worldwide was edentate, the standardised global age prevalence had a decrease from 4.4% to 2.4% of severe tooth loss in the entire population was seen between 1990 and 2010. 9As in this study, age has been proven in evidences as an influencing factor for causation of periodontitis since 1986's Srilankan longitudinal study till today. 10,11In recent study prevalence of periodontitis in middleaged and elderly individuals was seen to be high. 11reover bidirectional relationship between the age and periodontal disease by basic cellular and molecular research has been proven. 12In a study resulted that the prevalence of tooth loss in age above 40 years is due to chronic periodontitis where lower

CONCLUSION
This study demonstrated that mean of tooth loss due to periodontitis was found to be 3.74±3.285and tooth to be extracted is 1.94±1.884where increase in age was statistically significant with prevalence of tooth loss.Similarly, current smokers had seen with more amount of tooth loss than that of non-smokers which was statistically significant and mandibular anteriors were the prone areas for tooth loss compared to any other areas.

METHODSA
descriptive cross-sectional study was done to find out the prevalence of tooth loss in periodontitis patients visiting the Department of Periodontology and Oral Implantology in Kathmandu University school of medical sciences (KUSMS), Dhulikhel, Correspondence Dr. Sachita Thapa Email: sachitathapa56@gmail.com Citation Thapa S, Rijal AH, Humagain M, Lamichhane S. Prevalence of Tooth Loss due to Periodontitis in Patients Visiting Tertiary Care Hospital.J Nepal Soc Perio Oral Implantol.2023 Jul-Dec;7(14):55-9.

Table 1 :
Thapa et al: Prevalence of Tooth Loss due to Periodontitis in Patients Visiting Tertiary Care Hospital prevalence of all parameters, n (%) present study showed that among 216 patients of periodontitis where 101 (46.8%) participants were male while 115 (53.2%) participants were female.Age was categorized into five groups in interval of 10 starting with 30 and maximum age being 80 years.Based on categories of smoker's maximum number of tooth loss was seen in current smokers (4.70±3.549)while nonsmokers show a smaller number of tooth loss (2.79±2.953)which was found to be statistically

Table 2 :
Mean differences of tooth loss and to be extracted tooth.

Table 3 :
Mean differences of tooth loss and to be extracted compared with age.
Thapa et al: Prevalence of Tooth Loss due to Periodontitis in Patients Visiting Tertiary Care Hospital

Table 4 :
mean differences of tooth loss and to be extracted compared with smoking criteria cannot be generalized into the general population.Also, patient might not recall the actual cause of tooth loss which has occurred long time ago.